CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Texas Orthopedic Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $49
  • Cash Discount Price: $374
  • vs. Medicare Baseline: 1.69x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Texas Orthopedic Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $374. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.69x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$374

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)
Cash / Self-Pay: $374 (1287%)
Insurance Median: $49 (169%)
Cash: $374 (1287% of Medicare)
Ins. Median: $49 (169% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $29.06 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Superior Health Plan $21 - $96 72%
Oscar $25 - $313 86%
Amerigroup $26 - $225 89%
Blue Cross Blue Shield $26 - $562 89%
Cigna $26 - $29 89%
Devoted Health $26 - $29 89%
Humana $26 - $295 89%
Integranet Amerigroup Ipa $26 - $30 89%
Kelsey Seybold $26 - $29 89%
Triwest Healthcare Alliance $26 - $29 89%
United $26 - $723 89%
Van Lang Ipa $26 - $30 89%
Wellcare $26 - $30 89%
Wellmed $26 - $29 89%
American Health Plan $27 - $31 93%
Procare Advantage $27 - $31 93%
Provider Partners Health Plan Of Texas $27 - $31 93%
Shared Health $27 - $31 93%
Molina $28 - $32 96%
Christus (Usfhp) $29 100%
Universal Healthcare Group $31 - $35 107%
Verda Health Plan $33 - $38 114%
Community Health Choice $37 - $42 127%
Superior $37 - $45 127%
Community Health Choice Mcd $45 - $209 155%
Corvel Corporation $51 - $58 175%
Omni Healthcare $54 - $61 186%
Molina Healthcare $56 - $64 193%
Texas Childrens Health Plans $58 - $381 200%
Aetna $78 - $141 268%
Texas Workforce Commission $84 - $386 289%
Healthsmart Preferred Care $150 - $1,366 516%
Fidelis Securecare Of Tx $157 - $723 540%
Coventry National First Health $186 - $857 640%
Physicians Cooperative Of Texas $192 - $884 661%
Rockport Workers Comp $192 - $884 661%
Independent Medical System $210 - $964 723%
National Healthcare Solutions $210 - $964 723%
Southwest Medical $210 - $964 723%
Coastal Comp $227 - $1,045 781%
Multiplan $262 - $1,366 902%
International Health Insurance $280 - $1,286 964%
Physicians, Inc $297 - $1,366 1022%
Texas Athletic Network $300 - $600 1032%
Affiliated Ppo $315 - $1,446 1084%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals